6. Exposure to infection during pregnancy
Introduction
There are a good number of viruses which infect children and adults alike. To the majority of these, the body's immune system responds promptly and the infection is literally shrugged off in a matter of days. In a number of instances, the individual may be unaware that he or she has been suffering from an infection. Some types of viral infections have specific signs and symptoms and are easily identifiable. These include such infections as measles and chicken-pox.
The differences in the behaviour and course of viral infections do not end there. Significantly, some infections render the individual immune to them for the remainder of his or her life, including infections such as Rubella. Other viral infections may stay there for life, with occasional or sometimes frequent flare-ups; a typical example is genital herpes. Yet others may cause a chronic condition, which may be progressive and even fatal in the long-term; HIV infection is a case in point.
Just to add to the complexity of the picture is another subset of viral infections where the outcome is not immediately predictable. An example is Hepatitis B. If one is infected with Hepatitis B, rapidly progressive liver disease may ensue or the individual may develop a chronic condition with a capacity of passing on the disease to others, while remaining outwardly healthy for many years. Conversely, the infection may be completely cleared from the body by the immune system, leaving the individual immune for life. All these examples show how varied viral infections are and why doctors cannot possibly give standard advice to cover all of them.
While most viral infections are relatively inconsequential in non-pregnant individuals, pregnancy is a unique condition because of the developing fetus. The fetus is vulnerable and the vulnerability differs according to the stage- of gestation. An infection such as Rubella, relatively innocuous at other times, could have devastating effects when contracted in the first few weeks of pregnancy. Chicken-pox, which might be shrugged off if contracted at twenty weeks, might cause very serious problems if it bursts on the scene at term on the eve of labour.
All these are extensively explored and explained in detail in this chapter. It is important for the reader not to lose sight of the fact that complications of pregnancy due to infection are uncommon. However, if it occurs, it is important to know what that might mean and what needs to be done. On the bacterial front, the relatively common and relevant areas of interest such as urinary tract infection, sexually transmitted diseases and ascending infection (infection affecting the "waters") are discussed in detail.
Measles in Pregnancy
If I am exposed to measles during pregnancy, what should l do?
Don't panic. That is the first thing. Most adults of childbearing age will either have been vaccinated sometime in their childhood or would have had the infection. The immunity acquired from either is life-long and 95 per cent of all those who are vaccinated acquire this immunity.
This leaves only a small minority who may be susceptible during pregnancy. If you are unsure whether you have had the infection or been immunized, then you should contact your doctor promptly after exposure to have your status checked. If no records are available, then a simple blood test may establish whether you are immune or not.
If you are susceptible, an injection of a protective protein (immunoglobulin) may be administered to give you passive immunity. The protection from this is not total, but even if you go on to get the infection, it will be attenuated and therefore mild.